Hoffmann J, Jensen H E, Schulze S, Poulsen P E, Christiansen J
Br J Surg. 1984 Aug;71(8):582-5. doi: 10.1002/bjs.1800710803.
A prospective, randomized, controlled trial was performed to study truncal vagotomy and drainage (TV), selective vagotomy and drainage (SV) and parietal cell vagotomy (PCV) as elective treatment for duodenal ulcer. Five years postoperatively, 233 patients were available for study: 73 TV, 81 SV and 79 PCV. The ulcer recurrence rates were 13.6, 19.8 and 30.4 per cent respectively. The incidence of severe dumping was 4.9, 10.9 and 1.9 per cent; of severe diarrhoea 4.9, 6.3 and 1.9 per cent; of severe pain/dyspepsia 3.3, 6.3 and 3.8 per cent and of severe nausea/vomiting 0, 1.6 and 0 per cent respectively. Women suffered more postvagotomy symptoms than men. After treatment of recurrences and postvagotomy symptoms, more patients after PCV achieved excellent results than after TV and SV, as recurrences were easier to treat than severe postvagotomy symptoms. The only factor found contributing to the high ulcer recurrence following PCV was the large number of surgical trainees operating in the trial.
进行了一项前瞻性、随机、对照试验，以研究迷走神经干切断术加引流术（TV）、选择性迷走神经切断术加引流术（SV）和壁细胞迷走神经切断术（PCV）作为十二指肠溃疡的选择性治疗方法。术后五年，有233例患者可供研究：73例行TV，81例行SV，79例行PCV。溃疡复发率分别为13.6%、19.8%和30.4%。严重倾倒综合征的发生率分别为4.9%、10.9%和1.9%；严重腹泻的发生率分别为4.9%、6.3%和1.9%；严重疼痛/消化不良的发生率分别为3.3%、6.3%和3.8%；严重恶心/呕吐的发生率分别为0、1.6%和0。女性迷走神经切断术后的症状比男性更多。在治疗复发和迷走神经切断术后症状后，PCV术后获得优异结果的患者比TV和SV术后更多，因为复发比严重的迷走神经切断术后症状更容易治疗。发现导致PCV术后溃疡高复发率的唯一因素是试验中有大量外科实习医生参与手术。
